| 1 | Staged angioplasty versus regular carotid artery stenting in patients with carotid artery stenosis at high risk of hyperperfusion:a randomised clinical trial显示文摘Background and purpose Hyperperfusion(HP)is a devastating complication associated with carotid artery stenting(CAS)or endarterectomy.The efficacy and safety of staged angioplasty(SAP)in patients with CAS at high risk of HP remains unclear.We sought to determine whether SAP is superior to regular CAS in patients with high risk of HP.Methods A randomised,multicentre open-label clinical trial with blinded outcome assessment(STEP)was conducted.Patients with severe carotid stenosis at high risk of HP were randomly assigned(1:1)to the SAP or regular CAS group.The primary endpoint was hyperperfusion syndrome(HPS)and intracerebral haemorrhage(ICH)within 30 days after the procedure.Results From November 2014 to January 2017,a total of 64 patients were enrolled in 11 centres.33 patients were allocated to the SAP group and 31 to the regular CAS group.At 30 days,the rate of primary endpoint was 0.0%(0/33)in the SAP group and 9.7%(3/31)in the regular CAS group(absolute risk reduction(ARR),9.7%;95%CI−20.1% to 0.7%;p=0.11).As one of the secondary endpoints,the incidence of HP phenomenon(HPP)was lower in the SAP group than the regular CAS group(0.0%vs 22.6%,ARR,−22.6%;95% CI−36.8%to−10.2%;p=0.04).Conclusion The rate of HPS and ICH was not significantly lower in SAP group;the extended secondary endpoint of HPP,however,significantly reduced,which suggested that SAP may be a safe and effective carotid revascularisation procedure to prevent HP. | Dapeng Mo Baixue Jia Huaizhang Shi Yaxuan Sun Qingan Liu Chengzhe Fan Jianping Deng Jinglin Yuan Wei Wu Changchun Jiang Guilian Zhang Hanjun Du Ning Ma Feng Gao Xuan Sun Ligang Song Lian Liu Guangge Peng Yongjun Wang Yilong Wang Zhongrong Miao the STEP Study Group | 2021 | Stroke & Vascular Neurology2021，6，1： | 3 |
| 2 | The gut microbiome and microbial metabolites in acute myocardial infarction显示文摘Emerging evidence has highlighted the role of gut microbiome in human health.However,the integrative role of gut microbiome and microbial metabolites in acute myocardial infarction(AMI)remains unclear.The current study profiles the microbial community through 16S rRNA gene sequencing and shotgun metagenomic sequencing and measures fecal short-chain fatty acids and circulating choline pathway metabolites among 117 new-onset AMI cases and 78 controls.Significant microbial alternations are observed in AMI patients compared with controls(P=0.001).The abundances of nine species(e.g.,Streptococcus salivarius and Klebsiella pneumoniae)are positively associated,and one species(Roseburia hominis)is inversely associated with AMI status and severity.A gut microbial score at disease onset is associated with the risk of major adverse cardiovascular events in 3.2 years(hazard ratio[95%CI]:2.01[1.04-4.24])in AMI patients.The molar proportions of fecal acetate and butyrate are higher,and the circulating levels of choline and carnitine are lower in AMI patients than in controls.In addition,disease classifiers show that AMI cases and controls have a more distinct pattern in taxonomical composition than in pathways or metabolites.Our findings suggest that microbial composition and functional potentials are associated with AMI status and severity. | Chenglin Liu Zhonghan Sun Shalaimaiti Shali Zhendong Mei Shufu Chang Hanjun Mo Lili Xu Yanni Pu Huihui Guan Guo-Chong Chen Qibin Qi Zhexue Quan Ji Qi Kang Yao Yuxiang Dai Yan Zheng Junbo Ge | 2022 | Journal of Genetics and Genomics2022，49，6： | 0 |
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